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Accident Benefits: An Update on the Law

The law is never a fixed or static principle; it evolves with the passage of time and cases through the courts. Ontario’s auto insurance laws have provided for Accident Benefits for decades but the provincial government tinkered with the schedule of payments – i.e. what is payable and for how much – in recent years and the fallout is still occurring in our courts.

Naturally, when such legal adjustments occur, insurance companies look for wording that allows them to curtail the amount of benefits they are required to pay. Recent court decisions however have landed squarely on the side of accident victims and their families in finding a reasonable interpretation of the law.

What is an Economic Loss?

One of the benefits provided under the Accident Benefits statutes is for attendant care – i.e. hiring someone to look after you or your affairs when you are injured in a car accident. Part of the definition of what is covered (or not) has to do with the term “economic loss”. A service provider (your attendant helper) can claim any financial outlay that qualifies as an economic loss as well as for their services.

Insurers have tried to take a very strict and narrow view of this term as defined in in subsection 3(7)(e) of the Ontario statutory accident benefits schedule and attempted to restrict the payment of these benefits only to very limited and defined items. The courts have taken a different view.

The Financial Services Commission of Ontario arbitration board recently released a decision that essentially confirms that any financial outlay by a service provider can qualify as an economic loss within the meaning of the law.

The specific case involved an elderly woman who suffered an accident and was disabled. The expenses were claimed by her husband for parking and mileage as he went about looking after her affairs.

Previous cases have served to establish that the amount incurred should have no bearing on eligibility and because of that, the legislation was actually amended to include a cap on the amount payable on February 1, 2014.

This new ruling is important because it also establishes the notion of paying family members – who are, realistically speaking, often the best people for the job – for attendant care services in the same way that housekeeping and other professional services would be paid.

Attendant care expenses may also include things like communication with counsellors or other individuals. A case involving a woman with a brain injury was awarded the benefit for electronic communications with both family and support workers that she needed as an alternative to physical supervision.

We Can Help

If you’ve been denied accident benefits for any reason, contact our experienced accident benefits lawyers. We can advise you on the implications of any actions or requests and help you get –and keep – the benefits you deserve and need.

Insurance companies just aren’t on your side or looking out for your interests – they look out for their own. That’s where we come in. Contact Petrillo Law today by calling (905) 949-9433 for a free consultation with an experienced accident benefits lawyer. We look forward to hearing from you.